CANDACE DORALEE JACKSON

ASHDOWN, AR
NPI1962863381
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: AR  OT-A 1072)
Additional Taxonomies224Z00000X Occupational Therapy Assistant
(Licence: TX  213751)
Enumeration Date2016-03-11
Last Update Date2016-03-11
Business Address
-- CANDACE DORALEE JACKSON COTA/L
1470 RANKIN ST
ASHDOWN, AR 71822-3806
Phone number: 903-824-6589
Mailing Address
-- CANDACE DORALEE JACKSON COTA/L
1470 RANKIN ST
ASHDOWN, AR 71822-3806
Phone number: 903-824-6589